Pediatric and Adolescent Gynecology

Pediatric and Adolescent Gynecology focuses on conditions of the uterus, ovaries, vagina and vulva. Our team provides comprehensive evaluation and specialized treatment for these conditions in babies, children and teens. Each member of the team is trained in the special needs of growing girls and young women, both medical and emotional. We work closely with many kinds of healthcare providers to care for patients who have medical or developmental issues that can affect their reproductive health.

Conditions We Treat

We care for children and teens with a broad range of gynecological concerns, including:

Some children have differences (anomalies) in their reproductive organs that happen as the organs form. These differences are present at birth (congenital). They may be found at birth or not until later, such as at puberty. The organs inside the body (uterus, cervix, vagina and hymen) and outside the body (labia and clitoris) may be affected. Read more.(PDF)

Your child may have swelling, pain, itching or sores (ulcers) in the skin on the outside of their genitals. An infection, irritation or inflammatory disorder may trigger these symptoms. Treatment to control these problems and to soothe the skin may help.

The flaps of skin (labia) around the outside of the vagina may grow together in places (labial adhesions). Some children and teens have labia that are larger than average. This may cause discomfort. There may also be problems with the labia after female circumcision. Medicines like estrogen or steroid creams may be needed for conditions that affect the labia. Sometimes, surgery (labiaplasty) is needed.

Fluid (discharge) from the vagina helps to clean the vagina and protect it from infection. Unusual discharge may be a sign of a problem. Before puberty, it may be a sign of an infection, skin irritation, allergy, inflammation of the vulva or having an object (like pieces of toilet paper) in the vagina. After puberty, unusual discharge is often caused by a yeast infection, bacterial infection or sexually transmitted infection.

Vaginitis is an infection or inflammation of the vagina. If it also involves the outside of the genitals (vulva), it’s called vulvovaginitis. It can happen because of a yeast infection, sexually transmitted infection or other infection. It can also happen because the skin is irritated by laundry soap or bath products, for example. Also, young girls may get vaginitis if they are too small to fit well on the toilet seat. This may cause urine to enter their vagina when they urinate.

Signs of puberty, such as developing breasts and starting menstrual periods, usually begin in the early teens. The age range varies. Development may begin later for many reasons. Sometimes medical problems can delay puberty. In these cases, careful treatment with hormone medicines may help.

Teens may have a range of problems with their menstrual periods. Their periods may be hard to predict, painful, too frequent or too heavy, or they may not get periods. Often, these problems are symptoms of another condition.

In PCOS, the ovaries may not have a normal balance of hormones (estrogen, progesterone and androgens). The ovaries enlarge and develop many small, fluid-filled sacs (cysts). If your child has PCOS, they may not have a period each month. They may have acne or grow more hair on their body than usual. In some cases, PCOS may be treated with medicines to balance hormones and control menstrual periods.

Ovarian cysts tend to happen when the ovary is making an egg (follicle). If your child has cysts that are large, cause pain, limit blood flow to the ovaries or might be tumors, surgery may be needed. Most ovarian tumors are not cancer (they are benign). Most of the time, we can remove cysts with surgery using small incisions (minimally invasive techniques) and preserve the ovary and fallopian tube. Our goal is to preserve your child’s option to have children someday.

Services We Offer

Medicines may help with many gynecological problems, like vaginal infections or skin irritations. Hormones may improve some conditions, like polycystic ovary syndrome. Seattle Children’s gynecology team provides a full range of medical treatments for reproductive health concerns.

Taking steps to control your child’s or teen’s period may help with many kinds of issues. We offer treatment for heavy or painful periods, seizures linked to periods, endometriosis and other conditions. We can also help if your child has disabilities that make it hard to manage periods. The best options depend on each child’s or teen’s needs. At Children’s, options include hormones taken by mouth (orally) or through a skin patch (transdermally), Depo-Provera shots, intrauterine devices and other treatments.

When young people are thinking of using birth control (contraceptives) for family planning, healthcare providers can help them find a safe and effective method that fits their needs. Birth control pills (oral contraceptives) may also help treat some gynecological conditions, including some problems with periods. We offer long-term contraceptives that are reliable and safe in teens, such as Mirena and Implanon.

This is surgery done through a small “keyhole” cut (incision) in the bellybutton. The advantage of this technique is that surgeons don’t need to cut through as much tissue as when they make a longer incision. Your child or teen is likely to have less pain and to recover faster. This means returning sooner to school, sports or other activities. This technique leaves only a small scar, which you may not even be able to see, on the outside of the bellybutton. It also causes less scar tissue inside. So it is less likely to affect fertility. Gynecologic surgery is used most often to treat ovarian cysts and pelvic pain.

Sometimes, objects can get stuck in the vagina. The most common objects are pieces of toilet paper. Small toys or other objects can also get trapped. Sometimes a trapped object is the reason for unusual discharge. Our doctors may be able to remove an object during a clinic visit. Sometimes we need to do surgery.

We see many children and teens with differences in the way their reproductive organs formed. We work closely with providers from other areas of healthcare, including our Differences in Sex Development program, to diagnose these conditions and treat them, if needed. Our team offers a range of treatment options, both with surgery and without surgery.

Paying for Care

Learn about paying for care at Seattle Children’s including insurance coverage, billing and financial assistance.

Remote Access

Seattle Children’s complies with applicable federal and other civil rights laws and does not discriminate, exclude people or treat them differently based on race, color, religion (creed), sex, gender identity or expression, sexual orientation, national origin (ancestry), age, disability, or any other status protected by applicable federal, state or local law. Financial assistance for medically necessary services is based on family income and hospital resources and is provided to children under age 21 whose primary residence is in Washington, Alaska, Montana or Idaho.

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